Increased risk of SARS-CoV-2 reinfection associated with emergence of Omicron in South Africa

We provide two methods for monitoring reinfection trends in routine surveillance data to identify signatures of changes in reinfection risk and apply these approaches to data from South Africa's severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic to date. Although we found no evidence of increased reinfection risk associated with circulation of the Beta (B.1.351) or Delta (B.1.617.2) variants, we did find clear, population-level evidence to suggest immune evasion by the Omicron (B.1.1.529) variant in previously infected individuals in South Africa. Reinfections occurring between 1 November 2021 and 31 January 2022 were detected in individuals infected in all three previous waves, and there has been an increase in the risk of having a third infection since mid-November 2021.

Automated summary

This study provides two methods for monitoring reinfection trends in routine surveillance data. The results suggest immune evasion by the Omicron variant in previously infected individuals in South Africa, and there has been an increase in the risk of having a third infection since mid-November 2021.